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The Journal of Thoracic and... Feb 2016
Topics: Adipose Tissue; Decompression, Surgical; Female; Heart Diseases; Humans; Lipomatosis; Pericardiectomy; Pericardium
PubMed: 26578183
DOI: 10.1016/j.jtcvs.2015.10.050 -
International Journal of Molecular... Mar 2022The epicardium is the outermost cell layer in the vertebrate heart that originates during development from mesothelial precursors located in the proepicardium and septum... (Review)
Review
The epicardium is the outermost cell layer in the vertebrate heart that originates during development from mesothelial precursors located in the proepicardium and septum transversum. The epicardial layer plays a key role during cardiogenesis since a subset of epicardial-derived cells (EPDCs) undergo an epithelial-mesenchymal transition (EMT); migrate into the myocardium; and differentiate into distinct cell types, such as coronary vascular smooth muscle cells, cardiac fibroblasts, endothelial cells, and presumably a subpopulation of cardiomyocytes, thus contributing to complete heart formation. Furthermore, the epicardium is a source of paracrine factors that support cardiac growth at the last stages of cardiogenesis. Although several lineage trace studies have provided some evidence about epicardial cell fate determination, the molecular mechanisms underlying epicardial cell heterogeneity remain not fully understood. Interestingly, seminal works during the last decade have pointed out that the adult epicardium is reactivated after heart damage, re-expressing some embryonic genes and contributing to cardiac remodeling. Therefore, the epicardium has been proposed as a potential target in the treatment of cardiovascular disease. In this review, we summarize the previous knowledge regarding the regulation of epicardial cell contribution during development and the control of epicardial reactivation in cardiac repair after damage.
Topics: Adult; Cell Differentiation; Endothelial Cells; Epithelial-Mesenchymal Transition; Humans; Mesoderm; Pericardium
PubMed: 35328640
DOI: 10.3390/ijms23063220 -
CMAJ : Canadian Medical Association... Jun 2021
Topics: Aged; Calcification, Physiologic; Echocardiography; Humans; Male; Pericarditis, Constrictive; Pericardium; Tomography, X-Ray Computed
PubMed: 34099470
DOI: 10.1503/cmaj.202346 -
Physiological Research 2016Recent studies focused on epicardial fat, formerly relatively neglected component of the heart, have elucidated some of its key roles. It possesses several properties... (Review)
Review
Recent studies focused on epicardial fat, formerly relatively neglected component of the heart, have elucidated some of its key roles. It possesses several properties that can distinguish it from other adipose tissue depots. Its unique anatomical location in the heart predisposes the epicardial fat to be an important player in the physiological and biochemical regulation of cardiac homeostasis. Obesity is associated with an increase in epicardial fat mass. Excess of cardiac fat can contribute to greater left ventricular mass and work, diastolic dysfunction and attenuated septal wall thickening. Imbalance in adipokines levels secreted in autocrine or paracrine fashion by epicardial fat can contribute to the activation of the key atherogenic pathways in the setting of metabolic syndrome. Epicardial fat has also been identified as an important source of pro-inflammatory mediators worsening endothelial dysfunction, eventually leading to coronary artery disease. Increased production of pro-inflammatory factors by epicardial fat can also contribute to systemic insulin resistance in patients undergoing cardiac surgery. Here we review the most important roles of epicardial fat with respect to heart disease in the context of other underlying pathologies such as obesity and type 2 diabetes mellitus.
Topics: Adipose Tissue; Animals; Diabetes Mellitus; Heart Diseases; Humans; Obesity; Pericardium
PubMed: 26596323
DOI: 10.33549/physiolres.933036 -
Interactive Cardiovascular and Thoracic... Jun 2018Durability of bioscaffolds cross-linked with glutaraldehyde and used in cardiovascular surgery is limited by biomechanical instability, calcification and reduced... (Comparative Study)
Comparative Study
OBJECTIVES
Durability of bioscaffolds cross-linked with glutaraldehyde and used in cardiovascular surgery is limited by biomechanical instability, calcification and reduced biocompatibility. This study compares CardioCel®, a bovine pericardial scaffold engineered via the ADAPT® process to ensure optimized biostability and biocompatibility, with the commonly used bioscaffolds.
METHODS
Bovine pericardial scaffolds, cross-linked with 0.6% glutaraldehyde (XenoLogiX™, PeriGuard®), dye-mediated photo-oxidized (PhotoFix™) and a non-crosslinked porcine scaffold (CorMatrix®), were compared with CardioCel (decellularized, cross-linked with 0.05% monomeric glutaraldehyde, detoxified) by thermal stability and mechanical tests. Biocompatibility and calcification were assessed in a juvenile subcutaneous rat model at 6 and 12 weeks.
RESULTS
CardioCel displayed significantly higher (P < 0.01) cross-link stability (77.99 ± 0.64 °C) than CorMatrix (57.88 ± 0.22 °C) and PhotoFix (53.96 ± 0.41 °C). Tensile strength of CardioCel (8.31 ± 3.36 MPa) was comparable with XenoLogiX (11.00 ± 5.43 MPa, P = 0.734), PeriGuard (16.44 ± 6.69 MPa, P = 0.136), PhotoFix (7.10 ± 6.11, P = 0.399) and CorMatrix (9.75 ± 2.61, P = 0.204). XenoLogiX and PeriGuard recorded the highest Young's modulus (67.01 ± 30.36 vs 95.67 ± 45.91 MPa), while CardioCel (50.21 ± 19.92 MPa) was comparable with CorMatrix (36.78 ± 10.47 MPa, P = 0.204) and PhotoFix (33.50 ± 10.24, P = 0.399). CorMatrix displayed a significantly (P < 0.05) greater stiffness (4.74 ± 0.77 MPa) at 10% strain than PeriGuard (3.73 ± 1.79 MPa), PhotoFix (1.59 ± 0.40 MPa) and CardioCel (3.39 ± 0.83 MPa). Differences in extractable calcium did not reach significance; however, the inorganic phosphorus content of PhotoFix (21.3 ± 9.0 µg/mg) was higher than CardioCel (11.35 ± 0.76 µg/mg, P = 0.004) or PeriGuard (10.7 ± 2.18 µg/mg, P = 0.002) at 12 weeks. CardioCel underwent a typical mild host-graft response with fibroblast infiltration and remodelling. Foreign body reactions were visible in both XenoLogiX and PeriGuard, with isolated fibroblast infiltration. PhotoFix showed severe inflammation and 2 implants were completely degraded at 12 weeks.
CONCLUSIONS
CardioCel demonstrated optimized physical properties, minimal mineralization potential and superior biocompatibility. These results may benefit the long-term performance of this bioscaffold for cardiovascular surgery. The favourable characteristics of the comparator products were counterbalanced by less desirable features that may have negative implications on durability and performance when used in cardiovascular procedures.
Topics: Animals; Cattle; Elastic Modulus; Models, Animal; Pericardium; Rats; Swine; Tensile Strength; Tissue Scaffolds
PubMed: 29361133
DOI: 10.1093/icvts/ivx413 -
Adipocyte Dec 2022Predictors of overall epicardial adipose tissue deposition have been found to vary between males and females. Whether similar sex differences exist in epicardial fat...
Predictors of overall epicardial adipose tissue deposition have been found to vary between males and females. Whether similar sex differences exist in epicardial fat cell morphology is currently unknown. This study aimed to determine whether epicardial fat cell size is associated with different clinical measurements in males and females. Fat cell sizes were measured from epicardial, paracardial, and appendix adipose tissues of post-mortem cases (= 118 total, 37 females). Epicardial, extra-pericardial, and visceral fat volumes were measured by computed tomography from a subset of cases (= 70, 22 females). Correlation analyses and stepwise linear regression were performed to identify predictors of fat cell size in males and females. Median fat cell sizes in all depots did not differ between males and females. Body mass index (BMI) and age were independently predictive of epicardial, paracardial, and appendix fat cell sizes in males, but not in females. Epicardial and appendix fat cell sizes were associated with epicardial and visceral fat volumes, respectively, in males only. In females, paracardial fat cell size was associated with extra-pericardial fat volume, while appendix fat cell size was associated with BMI only. No predictors were associated with epicardial fat cell size in females at the univariable or multivariable levels. To conclude, no clinical measurements were useful surrogates of epicardial fat cell size in females, while BMI, age, and epicardial fat volume were independent, albeit weak, predictors in males only.
Topics: Adipocytes, White; Adipose Tissue; Female; Humans; Intra-Abdominal Fat; Male; Pericardium; Sex Characteristics
PubMed: 35531882
DOI: 10.1080/21623945.2022.2073854 -
Journal of Healthcare Engineering 2019Heart valve (HV) diseases are among the leading causes of cardiac failure and deaths. Of the various HV diseases, damaged HV leaflets are among the primary culprits. In...
Heart valve (HV) diseases are among the leading causes of cardiac failure and deaths. Of the various HV diseases, damaged HV leaflets are among the primary culprits. In many cases, impaired HV restoration is not always possible, and the replacement of valves becomes necessary. Bioprosthetic HVs have been used for the replacement of the diseased valves, which is obtained from the sources of bovine and porcine origin, while tissue-engineered heart valves (TEHV) have emerged as a promising future solution. The bioprosthetic valves are prone to become calcified, and thus they last for only ten to fifteen years. The adequate understanding of the correlations between the biomechanics and rheological properties of native HV tissues can enable us to improve the durability of the bioprosthetic HV as well as help in the development of tissue-engineered heart valves (TEHV). In this study, the structural and rheological properties of native bovine aortic HV and pericardium tissues were investigated. The microstructures of the tissues were investigated using scanning electron microscopy, while the rheological properties were studied using oscillatory shear measurement and creep test. The reported results provide significant insights into the correlations between the microstructure and viscoelastic properties of the bovine aortic HV and pericardium tissues.
Topics: Animals; Aortic Valve; Bioprosthesis; Cattle; Elasticity; Heart Valve Prosthesis; Pericardium; Rheology; Swine; Tissue Engineering; Viscosity
PubMed: 31976052
DOI: 10.1155/2019/3290370 -
European Radiology Experimental May 2022Our aim was to evaluate the reproducibility of epicardial adipose tissue (EAT) volume, measured on scans performed using an open-bore magnetic resonance scanner.
BACKGROUND
Our aim was to evaluate the reproducibility of epicardial adipose tissue (EAT) volume, measured on scans performed using an open-bore magnetic resonance scanner.
METHODS
Consecutive patients referred for bariatric surgery, aged between 18 and 65 years who agreed to undergo cardiac imaging (MRI), were prospectively enrolled. All those with cardiac pathology or contraindications to MRI were excluded. MRI was performed on a 1.0-T open-bore scanner, and EAT was segmented on all scans at both systolic and diastolic phase by two independent readers (R1 with four years of experience and R2 with one year). Data were reported as median and interquartile range; agreement and differences were appraised with Bland-Altman analyses and Wilcoxon tests, respectively.
RESULTS
Fourteen patients, 11 females (79%) aged 44 (41-50) years, underwent cardiac MRI. For the first and second readings, respectively, EAT volume was 86 (78-95) cm and 85 (79-91) cm at systole and 82 (74-95) cm and 81 (75-94) cm at diastole for R1, and 89 (79-99) cm and 93 (84-98) cm at systole and 92 (85-103) cm and 93 (82-94) cm at diastole for R2. R1 had the best reproducibility at diastole (bias 0.3 cm, standard deviation of the differences (SD) 3.3 cm). R2 had the worst reproducibility at diastole (bias 3.9 cm, SD 12.1 cm). The only significant difference between systole and diastole was at the first reading by R1 (p = 0.016). The greatest bias was that of inter-reader reproducibility at diastole (-9.4 cm).
CONCLUSIONS
Reproducibility was within clinically acceptable limits in most instances.
Topics: Adipose Tissue; Adolescent; Adult; Aged; Female; Humans; Magnetic Resonance Imaging; Middle Aged; Obesity; Pericardium; Reproducibility of Results; Young Adult
PubMed: 35606555
DOI: 10.1186/s41747-022-00274-0 -
Pharmacological Research Jan 2018Since the regenerative capacity of the adult mammalian heart is limited, cardiac injury leads to the formation of scar tissue and thereby increases the risk of... (Review)
Review
Since the regenerative capacity of the adult mammalian heart is limited, cardiac injury leads to the formation of scar tissue and thereby increases the risk of developing compensatory heart failure. Stem cell therapy is a promising therapeutic approach but is facing problems with engraftment and clinical feasibility. Targeting an endogenous stem cell population could circumvent these limitations. The epicardium, a membranous layer covering the outside of the myocardium, is an accessible cell population which plays a key role in the developing heart. Epicardial cells undergo epithelial to mesenchymal transition (EMT), thus providing epicardial derived cells (EPDCs) that migrate into the myocardium and cooperate in myocardial vascularisation and compaction. In the adult heart, injury activates the epicardium, and an embryonic-like response is observed which includes EMT and differentiation of the EPDCs into cardiac cell types. Furthermore, paracrine communication between the epicardium and myocardium improves the regenerative response. The significant role of the epicardium has been shown in both the developing and the regenerating heart. Interestingly, the epicardial contribution to cardiac repair can be improved in several ways. In this review, an overview of the epicardial origin and fate will be given and potential therapeutic approaches will be discussed.
Topics: Animals; Epithelial-Mesenchymal Transition; Heart Failure; Humans; Pericardium; Regeneration; Stem Cell Transplantation; Stem Cells
PubMed: 28751220
DOI: 10.1016/j.phrs.2017.07.020 -
Journal of Cardiothoracic Surgery Jul 2018Pericardial effusion (PE) is a common finding in patients who have chronic cardiac failure, who had undergone cardiac surgery, or who have certain other benign and...
BACKGROUND
Pericardial effusion (PE) is a common finding in patients who have chronic cardiac failure, who had undergone cardiac surgery, or who have certain other benign and malignant diseases. Pericardial drainage procedures are often requested for both diagnostic and therapeutic purposes. The perceived benefit is that it allows for diagnosis of malignancy or infection for patients with PEs of unclear etiology. The purpose of the study is to determine the diagnostic yield of surgical drainage procedures.
METHODS
We conducted a retrospective chart review of patients who underwent surgical drainage procedures of PEs from July 1st, 2011 to January 1st, 2017 at a single institution. The variables included data on preoperative, intraoperative, and postoperative findings; morbidity; and survival.
RESULTS
A total of 145 patients with an average age of 61 ± 5 and primarily men (53%) were evaluated. All of the surgical drainage procedures were performed through the sub-xiphoid approach. Twenty-five of the 145 patients (17.2%) had diagnostic findings in either the pericardial tissue or fluid. The cytology alone was diagnostic in 4.8% (N = 7) of patients with mixed findings including adenocarcinoma of the lung and breast. The pathology was diagnostic for cancer in 1.4% (N = 2) of patients with Melanoma and Lung cancer identified. The cytology and pathology were concordant in 4.0% (N = 6) identifying cancers that included mesothelioma and adenocarcinoma. Infection was identified in the pericardial fluid in 6.9% (N = 10) of the patients.
CONCLUSION
Surgical pericardial drainage procedures allow for removal of PE that may lead to tamponade physiology and potential mortality. Although there is therapeutic benefit from these procedures there is only a small diagnostic benefit.
Topics: Adult; Aged; Female; Humans; Male; Middle Aged; Pericardial Effusion; Pericardial Window Techniques; Pericardium; Retrospective Studies; Survival Rate; Treatment Outcome
PubMed: 30021617
DOI: 10.1186/s13019-018-0774-x